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Maine rates for HCPCS 97129

Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencing tasks), direct (one-on-one) patient contact; initial 15 minutes

Facilitymedian $24 · 10th–90th $24–$250%20%40%90th$24Professionalmedian $19 · 10th–90th $14–$380%10%10th90th$19$10.0$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $23.99 / $25.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $16.98 / $23.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $22.39 / $33.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $27.54 / $52.48
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $25.12 / $51.29
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $16.98 / $25.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $27.54 / $61.66